Serum creatinine/cystatin C ratio as a screening tool for sarcopenia and prognostic indicator for patients with esophageal cancer

Zheng, Chao; Wang, Ellen; Li, Jiangshan; Xie, Kai; Luo, Chao; Ge, Qi‐Yue; Hu, Liwen; Shen, Yi

doi:10.1186/s12877-022-02925-8

Cited by 41 publications

(58 citation statements)

References 43 publications

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“…The study showed that Cr/CysC ratio (OR = 4.722, 95% CI: 2.312-33.871, p = 0.002) remained an independent predictor of sarcopenia in GIST patients after adjustment of BMI, tumour size, risk classification and Cr by multivariate logistic regression analysis, which is consistent with previous findings in gastric cancer patients (18). In addition, a retrospective study by Zheng et al found that the ratio of Cr/CysC had a good diagnostic effect on sarcopenia in both men (AUC = 0.732) and women (AUC = 0.754) with oesophageal cancer (17). Similar results were obtained in the present study, the serum Cr/CysC ratio was a useful predictor of sarcopenia compared with other biomarkers (e.g., serum Cr, CysC), and subgroup analysis performed according to gender found that the serum Cr/CysC ratio could also predict sarcopenia in GIST patients.…”

Section: Discussionmentioning

confidence: 99%

“…Based on these characteristics, the calculation of the Cr/CysC ratio can be used to assess skeletal muscle metabolism and further screen patients for sarcopenia. Since its introduction, the serum Cr/CysC ratio has been widely evaluated as a valid, low-cost, and reproducible biomarker in a variety of diseases, such as gastric cancer (18), oesophagal cancer (17), idiopathic pulmonary fibrosis (33).…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, in patients with skeletal muscle mass loss, serum creatinine levels appear to decrease, whereas cystatin C levels do not decrease significantly. Based on these observations, the serum creatinine/cystatin C (Cr/CysC) ratio can further predict muscle mass and has been demonstrated in patients with oesophageal cancer (17), gastric cancer (18), non-small cell lung cancer (19), and chronic obstructive pulmonary disease (20). However, the association of Cr/CysC ratio with sarcopenia in GIST patients has not been reported.…”

Section: Introductionmentioning

confidence: 99%

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Serum creatinine/cystatin C ratio is a systemic marker of sarcopenia in patients with gastrointestinal stromal tumours

et al. 2022

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BackgroundIt is well known that sarcopenia is a common risk factor in patients with gastrointestinal tumours, which may negatively affect the clinical outcome and prognosis. Recent studies suggest that serum creatinine-cystatin C (Cr/CysC) ratio may be associated with sarcopenia, but this association lacks sufficient evidence in patients with gastrointestinal stromal tumours (GIST). Therefore, this study aimed to investigate whether the Cr/CysC ratio was associated with sarcopenia and recurrence-free survival (RFS) in patients with GIST.Materials and methodsThe study retrospectively analysed 413 patients with GIST who underwent surgical resection from January 2016 to January 2020. The serum Cr/CysC ratio was determined as a proxy for sarcopenia by comparing it with various biomarkers and Cox multifactorial analysis was used to determine the relationship between Cr/CysC ratio and prognosis.ResultsSerum Cr/CysC was positively correlated with skeletal muscle area (SMA) (r = 0.256, p < 0.001), skeletal muscle index (SMI) (r = 0.300, p < 0.001), and hand grip strength (HGS) (r = 0.251, p < 0.001). The area under the receiver operator characteristic curve for sarcopenic subjects with serum Cr/CysC ratio was significantly greater than other biomarkers (Cr/CysC: 0.840, CysC: 0.732, Cr: 0.518). The optimal cut-off value for Cr/CysC was 0.65, and patients in the high Cr/CysC group had a higher 3-year recurrence-free survival (RFS) than those in the low Cr/CysC group (92.72 vs. 72.46%, p < 0.001). Cox multifactorial analysis found that the Cr/CysC ratio was an independent risk factor for RFS in GIST patients (HR = 2.143, 95% CI: 1.431–5.459, p = 0.011).ConclusionSerum Cr/CysC ratio has satisfactory and comparable diagnostic accuracy, and prognostic value for sarcopenia in patients with GIST. Therefore, it can be a simple and practical clinical tool to screen sarcopenia in GIST patients. However, further studies are required to validate these findings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serum creatinine/cystatin C ratio is a systemic marker of sarcopenia in patients with gastrointestinal stromal tumours

et al. 2022

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“…They concluded that pectoralis muscle area, determined by CT scan at the time of ICU admission, was associated with 6-month and hospital survival, as well as ICU-free days, despite not being a good predictor of regaining an independent lifestyle after discharge. Zheng et al [ 38 ] demonstrated that lower CCR could be used to identify sarcopenia in patients with esophageal cancer and was associated with shorter overall survival. Further, they found the all-cause mortality risk gradually decreased with increased CCR.…”

Section: Discussionmentioning

confidence: 99%

Serum Creatinine/Cystatin C Ratio as a Predictor of In-hospital Mortality in Patients Hospitalized with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Chen

Zha

et al. 2022

Lung

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Purpose Low serum creatinine/cystatin C ratio (CCR) is associated with unfavorable characteristics in patients with chronic obstructive pulmonary disease (COPD); however, the relationship between CCR and in-hospital mortality of patients with acute exacerbation of COPD (AECOPD) is unexplored. Our objective was to assess the value of CCR for predicting in-hospital mortality of patients hospitalized with AECOPD. Methods Patients with AECOPD (n = 597) were retrospectively enrolled. Patient’s clinical characteristics and laboratory tests, including serum cystatin C and creatinine, were reviewed. The prediction value of CCR was evaluated using area under the receiver operating characteristic curve (AUC) values. Factors potentially impacting in-hospital mortality were investigated using univariate and multivariate logistic regression analyses. Results Mortality rate during hospitalization was 10.05%. CCR was lower in non-surviving vs. survived patients (41.67 vs. 61.52, P < 0.001). AUC value for CCR for in-hospital mortality prediction was 0.79 [95% confidence interval (CI) 0.73–0.85]. On multivariate logistic regression analysis, in-hospital mortality was strongly associated with CCR < 52.27 [odds ratio (OR) 6.23, 95% CI (3.00–12.92), P < 0.001], age ≥ 81 years [OR 2.97, 95% CI (1.20–7.37), P = 0.019], oxygenation index < 300 [OR 3.28, 95% CI (1.27–8.44), P = 0.014], CRP > 8 mg/L [OR 1.84, 95% CI (1.15–2.95), P = 0.012], and D-dimer > 500 ng/L [OR 5.19, 95% CI (1.51–17.79), P = 0.009]. Conclusions CCR was significantly lower, and is a potential prognostic indicator, in patients with AECOPD who died during hospitalization.

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“…As we all know, serum creatinine and cystatin C are both biomarkers for glomerular filtration and renal function. Recently, a surrogate marker for sarcopenia called sarcopenia index (SI) has deen developed, which is defined as serum creatinine (mg/dL)/cystatin C (mg/L) × 100 and can be used to evaluate the skeletal muscle mass (Kashani et al, 2017;Barreto et al, 2019;Ren et al, 2022;Zheng et al, 2022). As we know, serum creatinine is the derivative of the skeletal muscle protein and the production of serum creatinine changes with skeletal muscle mass.…”

Section: Introductionmentioning

confidence: 99%

Serum creatinine to cystatin C ratio and cognitive function among middle-aged and older adults in China

Zhu

Tan

et al. 2022

Front. Aging Neurosci.

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BackgroundThe sarcopenia index (SI, serum creatinine/serum cystatin C × 100) is recently suggested to be a reliable marker for sarcopenia. It has been reported that sarcopenia is associated with poorer cognition. The purpose of this study was to evaluate the correlation between SI and cognitive function among middle-aged and older adults from the China Health and Retirement Longitudinal Study (CHARLS).Materials and methodsA total of 6,442 participants ≥45 years of age were enrolled in this study from CHARLS between 2011 and 2012. Cognitive function was assessed by interview-based measurements, including orientation and attention, episodic memory, visuo-construction, and the total cognitive function. SI was calculated by serum creatinine (mg/dL)/cystatin C (mg/L) × 100. One-way analysis of variance (ANOVA) was used to compare the differences among groups divided according to SI quartiles by gender. Both linear and logistic regression models were applied to investigate the relationship between SI and cognitive function.ResultsAfter adjustment for potential confounders, we found SI was significantly and positively correlated with total cognitive function scores both in males and females [β = 0.014, 95% confidence interval (CI) 0.007 to 0.021, P < 0.001; β = 0.011, 95 CI% 0.003 to 0.018, P = 0.004; respectively]. Similarly, when the total cognitive function score was treated as a categorical variable according to quartiles in males and females, higher SI was related to better total cognitive function scores in both males and females [odds ratio (OR) = 1.147, 95% CI 1.028 to 1.279, P = 0.014; OR = 1.219, 95% CI 1.106 to 1.344, P < 0.001; respectively] following adjustment for confounders.ConclusionsLower sarcopenia index was correlated with a higher prevalence of cognitive impairment among middle-aged and older adults in China.

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Serum creatinine/cystatin C ratio as a screening tool for sarcopenia and prognostic indicator for patients with esophageal cancer

Cited by 41 publications

References 43 publications

Serum creatinine/cystatin C ratio is a systemic marker of sarcopenia in patients with gastrointestinal stromal tumours

Serum creatinine/cystatin C ratio is a systemic marker of sarcopenia in patients with gastrointestinal stromal tumours

Serum Creatinine/Cystatin C Ratio as a Predictor of In-hospital Mortality in Patients Hospitalized with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Serum creatinine to cystatin C ratio and cognitive function among middle-aged and older adults in China

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